﻿@model GestionSaludOcupacional.Portal.Base.ViewModels.HistoriaClinica.HistoriaClinicaRegistroViewModel
<div class="form-horizontal">
    <fieldset>
        <div class="row-fluid">
            <div class="span9">
                <legend>Incidente Historia Clinica</legend>
            </div>
            <div class="span3">
                <input class="btn btn-primary" type="submit" value="Guardar" data-bind="click: $parent.Guardar" />
                @Html.ActionLink("Cancelar", "Index", "Examen", null, new { @class = "btn" })
            </div>
        </div>
        <div class="row-fluid">
            <div class="span6">
                <div class="control-group">
                    <div class="control-label">
                        @Html.LabelFor(model => model.TipoExamen)
                    </div>
                    <div class="controls">
                        @Html.TextBoxFor(model => model.TipoExamen, new { @data_bind = "value: TipoExamen" })
                    </div>
                </div>
            </div>
            <div class="span6">
                <div class="control-group">
                    <div class="control-label">
                        @Html.LabelFor(model => model.ActividadEconomica)
                    </div>
                    <div class="controls">
                        @Html.TextBoxFor(model => model.ActividadEconomica, new { @data_bind = "value: ActividadEconomica" })
                    </div>
                </div>
            </div>
        </div>
        <div class="row-fluid">
            <div class="span6">
                <div class="control-group">
                    <div class="control-label">
                        @Html.LabelFor(model => model.Cargo)
                    </div>
                    <div class="controls">
                        @Html.TextBoxFor(model => model.Cargo, new { data_bind = "value: Cargo" })
                    </div>
                </div>
            </div>
            <div class="span6">
                <div class="control-group">
                    <div class="control-label">
                        @Html.LabelFor(model => model.FechaIngreso)
                    </div>
                    <div class="controls">
                        @Html.TextBoxFor(model => model.FechaIngreso, new { data_bind = "datepicker: FechaIngreso" })
                    </div>
                </div>
            </div>
        </div>
        <div class="row-fluid">
            <div class="span6">
                <div class="control-group">
                    <div class="control-label">
                        @Html.LabelFor(model => model.Arp)
                    </div>
                    <div class="controls">
                        @Html.TextBoxFor(model => model.Arp, new { data_bind = "value: Arp" })
                    </div>
                </div>
            </div>
            <div class="span6">
                <div class="control-group">
                    <div class="control-label">
                        @Html.LabelFor(model => model.Afp)
                    </div>
                    <div class="controls">
                        @Html.TextBoxFor(model => model.Afp, new { data_bind = "value: Afp" })
                    </div>
                </div>
            </div>
        </div>
        <div class="row-fluid">
            <div class="control-group">
                <div class="control-label">
                    @Html.LabelFor(model => model.Eps)
                </div>
                <div class="controls">
                    @Html.TextBoxFor(model => model.Eps, new { data_bind = "value: Eps" })
                </div>
            </div>
        </div>
        <div class="row-fluid">
            <div class="control-group">
                <div class="control-label">
                    @Html.LabelFor(model => model.ContactoEmergencia)
                </div>
                <div class="controls">
                    @Html.TextBoxFor(model => model.ContactoEmergencia, new { data_bind = "value: ContactoEmergencia" })
                </div>
            </div>
        </div>
    </fieldset>
</div>
